Chronic Pain

Chronic pain can be defined as pain that is lasting, off and on, and lasts for 3 to 6 months or longer. Many things cause chronic pain, which can make it difficult to make a discrete diagnosis. There are many treatment options available for chronic pain. However, finding a treatment that works well for you may require trying various approaches until a suitable one is found.

CAUSES

In some types of chronic medical conditions, the pain is caused by a normal pain response within the body. A normal pain response helps the body identify illness or injury and prevent further damage from being done. In these cases, the cause of the pain may be identified and treated, even if it may not be cured completely. Examples of chronic conditions which can cause chronic pain include:

  • Inflammation of the joints (arthritis).

  • Back pain or neck pain (including bulging or herniated disks).

  • Migraine headaches.

  • Cancer.

In some other types of chronic pain syndromes, the pain is caused by an abnormal pain response within the body. An abnormal pain response is present when there is no ongoing cause (or stimulus) for the pain, or when the cause of the pain is arising from the nerves or nervous system itself. Examples of conditions which can cause chronic pain due to an abnormal pain response include:

  • Fibromyalgia.

  • Reflex sympathetic dystrophy (RSD).

  • Neuropathy (when the nerves themselves are damaged, and may cause pain).

DIAGNOSIS

Your caregiver will help diagnose your condition over time. In many cases, the initial focus will be on excluding conditions that could be causing the pain. Depending on your symptoms, your caregiver may order some tests to diagnose your condition. Some of these tests include:

  • Blood tests.

  • Computerized X-ray scans (CT scan).

  • Computerized magnetic scans (MRI).

  • X-rays.

  • Ultrasounds.

  • Nerve conduction studies.

  • Consultation with other physicians or specialists.

TREATMENT

There are many treatment options for people suffering from chronic pain. Finding a treatment that works well may take time.

  • You may be referred to a pain management specialist.

  • You may be put on medication to help with the pain. Unfortunately, some medications (such as opiate medications) may not be very effective in cases where chronic pain is due to abnormal pain responses. Finding the right medications can take some time.

  • Adjunctive therapies may be used to provide additional relief and improve a patient's quality of life. These therapies include:

  • Mindfulness meditation.

  • Acupuncture.

  • Biofeedback.

  • Cognitive-behavioral therapy.

  • In certain cases, surgical interventions may be attempted.

HOME CARE INSTRUCTIONS

  • Make sure you understand these instructions prior to discharge.

  • Ask any questions and share any further concerns you have with your caregiver prior to discharge.

  • Take all medications as directed by your caregiver.

  • Keep all follow-up appointments.

SEEK MEDICAL CARE IF:

  • Your pain gets worse.

  • You develop a new pain that was not present before.

  • You cannot tolerate any medications prescribed by your caregiver.

  • You develop new symptoms since your last visit with your caregiver.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop muscular weakness.

  • You have decreased sensation or numbness.

  • You lose control of bowel or bladder function.

  • Your pain suddenly gets much worse.

  • You have an oral temperature above 102° F (38.9° C), not controlled by medication.

  • You develop shaking chills, confusion, chest pain, or shortness of breath.